The Utility of Monitoring Beta-Human Chorionic Gonadotropin Levels in an Ectopic Pregnancy.
beta-human chorionic gonadotropin (β-hcg)
ectopic pregnancy
pregnancy surveillance
transvaginal ultrasound
tubal ectopic pregnancy
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
accepted:
22
01
2023
entrez:
26
1
2023
pubmed:
27
1
2023
medline:
27
1
2023
Statut:
epublish
Résumé
Ectopic pregnancy, a rare complication involving embryo nidation outside the uterus, significantly impacts women's lives worldwide. About 95% of ectopic pregnancies occur in the Fallopian tubes. If not diagnosed early, the patient may suffer from tubal rupture, resulting in hemorrhage and lethal consequences. Transvaginal ultrasound (TVUS) is typically used to diagnose an ectopic pregnancy. However, over the last decade, monitoring beta-human chorionic gonadotropin (β-hCG) levels in ectopic pregnancy have evolved to detect ectopic pregnancy. But there are inconsistencies in its utility in monitoring or diagnosing ectopic pregnancy in clinical practice. This systematic review highlights the potential of monitoring β-hCG levels to accurately diagnose ectopic pregnancy. Furthermore, it showcases if β-hCG levels can determine effective treatment options to successfully resolve an ectopic pregnancy. We performed a literature search between January 2022 through December 2022 following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The clinical evidence demonstrated that monitoring β-hCG levels, combined with TVUS, accurately diagnosed an ectopic pregnancy. Moreover, pre-treatment β-hCG levels higher than 5000 international units per liter (IU/L), statistically significant, indicated surgical management for a successful resolution of an ectopic pregnancy. Whereas lower β-hCG levels showed successful management through expectant and methotrexate treatment. Interestingly, patients who failed non-surgical treatment developed increased β-hCG levels and required surgical intervention. However, there was conflicting evidence on whether β-hCG levels could indicate tubal rupture. Nevertheless, as highlighted in this review, monitoring β-hCG levels could be crucial in the early diagnosis of ectopic pregnancy. Besides, it might significantly aid in monitoring and deciding on effective treatment options for patients with ectopic pregnancy, which could be vital to saving their lives and preserving fertility.
Identifiants
pubmed: 36699108
doi: 10.7759/cureus.34063
pmc: PMC9867943
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
e34063Informations de copyright
Copyright © 2023, Hirschler et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Ann Emerg Med. 2011 Jul;58(1):12-20
pubmed: 21310509
J Ultrasound Med. 2011 Dec;30(12):1637-42
pubmed: 22123998
PLoS One. 2022 May 24;17(5):e0268741
pubmed: 35609041
Arch Gynecol Obstet. 2012 Apr;285(4):1043-8
pubmed: 22002409
Cureus. 2021 Feb 2;13(2):e13089
pubmed: 33728112
Reprod Biol Endocrinol. 2021 Jun 1;19(1):79
pubmed: 34059064
Plast Reconstr Surg. 2011 Jul;128(1):305-310
pubmed: 21701348
Ann Emerg Med. 1996 Jul;28(1):10-7
pubmed: 8669724
J Clin Diagn Res. 2016 Jul;10(7):QC08-10
pubmed: 27630909
Obstet Gynecol. 2006 Feb;107(2 Pt 1):399-413
pubmed: 16449130
Int J Reprod Biomed. 2022 Apr 21;20(3):177-184
pubmed: 35571502
J Ayub Med Coll Abbottabad. 2017 Jan-Mar;29(1):65-67
pubmed: 28712177
J Matern Fetal Neonatal Med. 2015 Apr;28(6):695-9
pubmed: 24871360
BMJ Clin Evid. 2015 Nov 16;2015:
pubmed: 26571203
Hum Reprod. 2006 Oct;21(10):2706-10
pubmed: 16790610
Gynecol Endocrinol. 2019 Dec;35(12):1021-1026
pubmed: 31322446
Australas J Ultrasound Med. 2011 May;14(2):29-33
pubmed: 28191110
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Obstet Gynecol Surv. 2013 Aug;68(8):571-81
pubmed: 23921671
J Res Med Sci. 2014 Sep;19(9):844-9
pubmed: 25535498
Reprod Sci. 2022 Apr;29(4):1209-1214
pubmed: 35157263
BMC Womens Health. 2015 May 21;15:43
pubmed: 25994203
Ultrasound Obstet Gynecol. 2005 Dec;26(7):770-5
pubmed: 16308901
Matern Child Health J. 2020 Feb;24(2):213-221
pubmed: 31848926
Hum Reprod. 2005 May;20(5):1404-9
pubmed: 15695311
Medicine (Baltimore). 2022 Jun 17;101(24):e29514
pubmed: 35713461
Hum Reprod. 2002 Dec;17(12):3224-30
pubmed: 12456628